Commonwealth of Massachusetts
Division
The Trial Court Probate and Family Court Department
Docket No.
AFFIDAVIT OF IRRETRIEVABLE BREAKDOWN
Petitioner
V.
Petitioner
Petitioners state that our marriage has suffered an irretrievable breakdown which began on or about
(Date)
.
In particular, our marriage has suffered an irretrievable breakdown because:
Signed under the penalties of perjury. Date .
PETITIONER
PETITIONER
(Signature)
(Signature)
(Please Print)
(Please Print)
(Street address)
(Street address)
(City/Town)
(State)
(Zip)
(City/Town)
(State)
(Zip)
(Affid. Irretrievable Breakdown 4/07)
C.G.F.